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10 myths about wound healing.

Scratches, wounds, burns, cuts... the way we care for these injuries can impact their ability to heal and encounter complications such as infection. However, there are certain practices to avoid to ensure faster healing. Here are the ten most common misconceptions about wound care that we believe to be true and continue to persist.

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Myth No.1: A wound heals better when left exposed to the open air.

On the contrary, the wound is exposed to external elements, increasing the risk of infection and therefore complications. Furthermore, wounds that are exposed to the air will form a scab, which will make the healing of a wound difficult. Under such conditions, new skin tissues will struggle to form, which will prevent the skin from healing.Finally, numerous scientific studies have shown that a wound heals much better and faster when it is covered with a dressing from the first day until its complete healing.

What to do?

After cleansing your wound with clear water, apply an appropriate dressing. This will help to create, maintain and control a moist environment conducive to healing. Indeed, epidermal cells can migrate more easily, which accelerates epithelialisation and granulation.

Myth No. 2: Applying a plaster promotes the growth of germs.

There is a common misconception that keeping a wound covered and moist will encourage bacterial growth. Not only does a covered wound heal faster, but the dressing also prevents foreign bodies from entering, significantly reducing the risk of infection. That being said, wounds can also be too moist, which can pose a risk of tissue maceration. Indeed, an airtight dressing, such as a polyethylene film, will maintain a warm and moist environment on the wound surface and is not without risk of sepsis. The serous exudate (physiological fluid) can act as a suitable medium for bacterial proliferation. It is more beneficial for a gas exchange to occur between the wound surface and the external environment, thus limiting contamination by bacteria and foreign bodies.

What to do?

There are various types of dressings designed to help achieve optimal skin hydration to speed up recovery. Opt for dressings made from micro-porous materials, semi-permeable to air and water vapour, and absorbent. They provide mechanical protection, absorb excess exudate and maintain moisture. Moreover, it is important that the dressing materials do not adhere to the wound surface, as the migrated epithelial cells may be torn off with each dressing change.

Myth No. 3: The more you care for your wound, the smaller the scar will be.

It's true! The way you care for your wound has a direct impact on its healing. If you don't take proper care of it, you can increase the risk of infection or complications. The use of non-adherent sterile dressings, antibiotic ointments, and physiological solutions will significantly enhance the wound healing process and facilitate healthy recovery. If you're unsure about how to care for your wound, discuss it with your doctor.

Myth No. 4: Using alcohol or hydrogen peroxide to clean and disinfect wounds.

Alcohol and hydrogen peroxide (also known as oxygenated water) are very popular and commonly used solutions for disinfecting wounds and removing impurities. However, rubbing a wounded skin with alcohol or hydrogen peroxide can have drawbacks. Although they have antiseptic properties, they can also potentially damage the surrounding healthy cells and tissues. They can also cause irritations and inflammations, as well as protein degradation. These solutions can therefore hinder the healing of wounds, particularly in the case of burns.

What to do?

Cleaning the wound is a crucial step for proper healing. The best solution is to clean any new wound with warm soapy water or a compress soaked in saline solution, from the centre outwards, to remove dirt, blood and debris cluttering the wound. After cleaning the wound, disinfect it to minimise the risk of infection. Opt for a broad-spectrum and non-irritating antiseptic, such as an iodine-based antiseptic or one formulated with hexamidine or chlorhexidine.

Myth No. 5: Minor wounds do not need to be treated.

Small injuries also need to be treated, as they can become infected and cause medical issues if left untreated. They must be properly cleaned and protected. Any type of cut is a potential entry point for bacteria and germs, and so it is extremely important to treat and cover each wound.

Myth No. 6: Sea water accelerates the wound healing process.

It is common to hear, especially in summer, that seawater would aid a wound to heal better, but this is a myth. In reality, the contact of a wound with salt water can cause the skin to swell, which will impact the closure of the wound, not to mention the high risk of infection it can cause, and irritation and delay in wound healing. Seawater has no sterilising or healing virtues, and contains high amounts of microbes and impurities.

Myth No. 7: The formation of a scab is a sign of good healing.

Contrary to popular belief, scabs that form when wounds are left to dry in open air can actually hinder cellular growth and thus slow down the healing process. Scabs can also conceal inflamed tissues and bacteria, potentially leading to an infection, and increase the risk of scarring. If the wound is significant, it is advisable to seek medical attention periodically. Moreover, appropriate wound care can also reduce the risk of leaving an unsightly scar once the wound has healed.

What to do?

If a scab has formed, avoid scratching it to prevent reopening your wound, touching it, or attempting to conceal it with makeup. Instead, moisturise it with a cream to soften the scab and speed up its natural shedding process.

Myth No. 8: A wound needs to be kept dry.

While it may seem logical that keeping a wound dry would promote better healing, the reality is quite the opposite. Studies have shown that wet wounds heal two to three times faster than dry wounds. Apparently, for wounds to heal properly, they require a certain degree of moisture. Regular irrigation of a wound has several benefits that result in faster and higher quality healing: it reduces the formation of bedsores, it increases the migration and rapid re-epithelialisation of keratinocytes on the wound surface, it promotes collagen synthesis by stimulating fibroblasts, it reduces inflammation, it minimises the risk of scarring, and it promotes the autolysis of necrotic tissue in the wound. On the other hand, dry wounds can cause lesions, are more susceptible to infections, and result in longer healing times.

What to do?

To do this, consider applying a bit of topical antibiotic ointment or vaseline on the wound. Then cover it with a suitable dressing to keep it clean, which should be changed at least once a day.

Myth No. 9: Slow wound healing is normal.

Far from it, a slow healing of a wound could be a symptom of a disease such as diabetes, indicating a weakened immune system or blood circulation problems. Therefore, it is important to have your wound checked by a doctor if you notice that the healing is taking longer than usual, even if you are treating it properly.

Myth No. 10: Deeper wounds cause more pain.

On the contrary! Superficial wounds are more painful, given that they affect the nerve endings located just beneath the upper layer of the epidermis. Therefore, everyday cuts, scratches and grazes require as much protection and care as larger or deeper wounds.

Sources

  • MAIBACH H. I. & al. Effect of air exposure and occlusion on experimental human skin wounds. Nature (1963).

  • ERIKSSON E. & al. Moist wound healing with commonly available dressings. Advances in Wound Care (2021).

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